镍钛再治疗器械和不锈钢器械去除根管充填物效果的系统评价

发布时间：2018-07-03 01:47

本文选题：镍钛器械 + 根管再治疗　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:运用Meta分析的研究方法,比较镍钛再治疗器械(选取Pro Taper Universal Retreatment,PTUR)和不锈钢器械(ISO K锉、H锉)去除根管充填物的效果,以期对临床工作中去除根管充填物时选择器械提供依据。方法:1.文献检索采用计算机检索与手工检索相结合的方法,检索7个数据库自建库至2017年3月,所有有关镍钛再治疗器械和不锈钢器械去除根管充填物效果的研究。2.文献筛选根据PICOS原则、排除标准及质量评价手册筛选、评价文献。3.统计分析应用Rev Man 5.3对相关研究数据进行Meta分析。结果:最终共有符合纳入标准的文献9篇,共纳入实验牙齿294颗,不锈钢器械组共计147颗,PTUR组共计147颗。结果显示,比较PTUR和不锈钢器械去除弯曲根管充填物后残留物量,PTUR组高于手用不锈钢器械组,差异存在统计学意义[SMD=0.36,95%CI(0.01,0.72),P=0.04];比较PTUR和不锈钢器械去除直根管充填物后残留物量,手用不锈钢器械组高于PTUR组,差异存在统计学意义[SMD=-1.28,95%CI(-1.77,-0.78),P0.00001]。比较PTUR和不锈钢器械去除充填物所用时间,使用溶剂情况下,手用不锈钢器械组比PTUR组用时长,差异存在统计学意义[SMD=-1.62,95%CI(-2.12,-1.12),P0.00001];不用溶剂情况下手用不锈钢器械组比PTUR组用时长,差异存在统计学意义[SMD=-3.11,95%CI(-3.84,-2.39),P0.00001]。因此无论是否使用溶剂,不锈钢器械所用时间均比PTUR长。推出根尖孔碎屑量由于纳入研究异质性过大,因此不做meta分析。结论:1.在弯曲根管中,使用不锈钢器械去除根管充填物后残留物量比使用PTUR少。2.在直根管中,使用PTUR去除根管充填物后残留物量比使用不锈钢器械少。3.无论是否使用溶剂,使用PTUR去除根管充填物所用时间都比使用不锈钢器械短。4.综上,临床操作中去除根管充填物时,为缩短操作时间同时达到更好的根管清理效果,直根管中可采用PTUR,弯曲根管可先使用PTUR再使用不锈钢器械。
[Abstract]:Objective: to compare the results of removing root canal filling with Pro Taper Universal RetreatmentPTUR and ISO K file by Meta-analysis. In order to provide a basis for the selection of instruments for removing root canal filling in clinical work. Method 1: 1. Through the combination of computer retrieval and manual retrieval, 7 databases were searched until March 2017. All the studies on the effect of removing root canal filling with nickel titanium retreatment instruments and stainless steel instruments were studied. Literature screening according to PICOS principle, exclusion criteria and quality evaluation manual screening, evaluation document. 3. 3. Rev Man 5.3 was used to analyze the relevant data. Results: a total of 9 articles were included, including 294 experimental teeth, 147 stainless steel instruments group and 147 PTUR groups. The results showed that the residual amount of PTUR and stainless steel instruments after removal of curved root canal filling and PTUR group was higher than that of hand stainless steel instrument group, and the difference was statistically significant [SMDN 0.36 ~ 9595 CI (0.01 ~ 0.72) Pu 0.04], and the residual amount of PTUR and stainless steel instrument after removing straight root canal filling was compared. The difference between the stainless steel instrument group and PTUR group was statistically significant [SMD-1.28595 CI (-1.77-0.78) (P0.00001)]. The time taken to remove the filling was compared between PTUR and stainless steel instruments. When the solvent was used, the time used in the manual stainless steel instrument group was longer than that in the PTUR group. The difference was statistically significant [SMD-1.62N95 CI (-2.12 ~ 1.12) CI (-2.12 ~ -1.12)] P 0.00001, and the time used in the stainless steel instrument group without solvent was longer than that in the PTUR group. The difference was statistically significant [SMD-3.1195 CI (-3.84 -2.39) P 0.00001]. Therefore, stainless steel instruments take longer time than PTUR whether or not solvent is used. The amount of root apical foramen debris was not analyzed by meta because the heterogeneity of the study was too large. Conclusion 1. In curved root canal, the residual amount after removing root canal filling with stainless steel instrument was less than that with PTUR. In the direct root canal, the residual amount of PTUR after removing root canal filling was less than that of stainless steel instrument. With or without solvent, it takes less time to remove root canal fillers with PTUR than with stainless steel. In conclusion, in order to shorten the operation time and achieve better root canal cleaning effect, PTURs can be used in the straight root canal, and PTUR then stainless steel instrument can be used in the curved root canal.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.05

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